1. Technical Field
The present disclosure relates to a surgical instrument for installing fasteners into tissue. More particularly, the present disclosure relates to a powered tacker instrument for use in applying surgical fasteners through a prosthetic mesh and into tissue during hernia repair surgery.
2. Background of Related Art
Various surgical procedures require instruments capable of applying fasteners to tissue to form tissue connections or to secure objects to tissue. For example, during hernia repair procedures it is often desirable to fasten a mesh to body tissue. In certain hernias, such as direct or indirect inguinal hernias, a part of the intestine protrudes through a defect in the abdominal wall to form a hernial sac. The defect may be repaired using an open surgery procedure in which a relatively large incision is made and the hernia is closed off outside the abdominal wall by suturing. The mesh is attached with sutures over the opening to provide reinforcement.
Less invasive surgical procedures are currently available to repair a hernia. For example, in laparoscopic procedures, the hernia repair surgery is performed through a small incision in the abdomen while in endoscopic procedures, the hernia repair surgery is performed through narrow endoscopic tubes or cannulas inserted through small incisions in the body. Laparoscopic and endoscopic procedures generally require the use of long and narrow surgical instruments capable of reaching deep within the body and configured to seal with the incision or tube they are inserted through. Additionally, the instruments must be capable of being actuated remotely, that is, from outside the body.
Currently, endoscopic techniques for hernia repair utilize fasteners, such as, surgical staples or clips, to secure the mesh to the tissue to provide reinforcement in the repair and structure for encouraging tissue regrowth. The staples or clips are compressed against the tissue and mesh to secure the two together.
One other type of fastener suited for use in affixing mesh to tissue, during procedures such as hernia repair, is a coil fastener having a helically coiled body portion terminating in a tissue penetrating tip or a hollow screw type fastener having an external thread. Unique instruments have been developed to rotate these fasteners into tissue. Examples of some of these types of surgical fasteners and surgical instruments are disclosed in U.S. Pat. Nos. 5,258,000 and 5,830,221, the contents of which are incorporated by reference herein.
Most surgical instruments for applying fasteners to tissue can be actuated without the distal end of the surgical instrument actually in contact with tissue. This may result in a fastener being inadvertently ejected prior to placement against tissue or only partially installed in tissue.
In hernia repair surgery it is necessary to place multiple fasteners through a prosthetic mesh and into tissue. Often it is necessary to actuate the surgical instrument several times to rotate a single fastener through the mesh and into tissue. This can cause fatigue in the operator's hand. Additionally, it may be necessary to use a large amount of force on the actuator to install the fastener through various stiffness meshes resulting in further fatigue to the user's hand.
Thus, there is a need for a surgical instrument which can not be actuated to apply a fastener until the surgical instrument is securely positioned against the target tissue.
Furthermore, there is also need for a surgical instrument which has a power source to easily and comfortably install multiple fasteners and provide sufficient torque to drive the fasteners through a prosthetic mesh and into tissue.